10/25 Eating Disorders - Frenkel Flashcards
anorexia nervosa
diagnostic criteria
- restriction of energy intake relative to requirements leading to significantly low body weight in context of age, sex, developmental trajectory, and physical health
- intense fear of weight gain/becoming fat, behavior that interferes with weight gain (despite being underweight)
- disturbance in way weight or shape is experienced
types:
- restricting type
- bing-eating/purging type
medical complications of AN
- low bp
- amenorrhea and repro problems
- kidney issues
- GI issues
- osteoporosis
- edema
- cardiac irreg
Keys Starvation study
in WWII, group of conscientious objector agreed to go on a starvation diet for signif period of time (~6mo)
researchers learned that following behaviors are secondary effects of starvation → heavy overlap with anorexia
- food preoccupations
- bizarre eating habits
- incr irritability
- incr depression
- impaired concentration
- sleep difficulty
- decr sexual interest
- social isolation
bulemia nervosa
diagnostic criteria
recurrent episodes of binge eating characterized by:
- eating MORE FOOD in discrete amt of time than typically expected
- lack of control over eating during episode
recurrent inapprop compensatory behavior to prevent weight gain
- purging
- exercise purging
episodes occuring at least weekly for 3mo
overemphasis on body shape or weight on self-eval
episodes occuring NOT solely during episodes of AN
medical consequences of BN
- eletrolyte imbalance (due to purging)
- cardiac irreg
- dental problems
- damage to throat, esophagus, stomach
- laxative dependence
- GI issues
binge eating disorder
diagnostic criteria
recurrent episodes of binge eating characterized by:
- eating more than typically expected in a discrete amt of time
- lack of control over eating during the episode
binge eating episodes are associated with 3+ of following
- eating more rapidly than normal
- eating until feeling uncomfortably full
- eating large amt of food when not physically hungry
- eating alone (embarassed about amt of consumption)
- feeling disgusted with self, depressed, guilty afterwards
marked distress regarding binge eating
on avg, at least weekly for 3mo
not associated with recurrent use of compensatory behavior, does not occur during course of AN or BN
medical consequences of BED
- significant weight gain (sometimes, not always)
- high bp
- high cholesterol
- incr risk of diabetes
emotional and cognitive chars of eating disorders
- mood shifts (incl depression, sadness, guilt, self-hate)
- fear of becoming fat
- fear of food/situations with food present
- perfectionisitic attitude, self-criticism
- insecurities, issues with self-worth
- need for approval
- withdrawal
- may or may not want help
- anorexics often resistant (proud)
- bulemics want help with purging (shame) but still want weight loss
- binge eaters want to eat but without weight gain
physical signs of eating disorders
- significant shifts in weight
- loss of menstrual cycle or menstrual irregularities without other med reason
- paleness, cold, lanugo (hair growth to assist with coldness)
- impaired concentration
etc.
behavioral signs of eating disorders
- signs of restricted eating (severe diets, fasting)
- odd food rituals
- rigid exercise regimes
- dressing in layers (hide wt loss)
- binge eating
- purging
- use of laxatimes, diuretics, diet pills, enemas
- secretive eating
- excessive br visits after eating
- preoccupation with food/weight
- avoidance of social events with food
other specified feeding or eating disorder
all criteria for AN met BUT weight in normal range despite significant weight loss
criteria met for BN/BED except for frequency
1. avoidant/restrictive food intake disorder (ARFID) → picky eating (mostly kids) but dont have body-image issues
- weight loss, picky eating without body image disortion
- common among pt with Parvasive Devptal Disorders
2. purging disorder
- in approp compensatory behavior after eating small amt of food (in individ with normal body weight)
3. rumination
4. night eating syndrome
ddx for AN, BN, BED
- significant weight loss
- restricting
- binge-eating
- purging
unique combos:
AN = significant weight loss + restricting
BN = binging + purging
BED = binging + NO purging
medical conditions that can mimic or cause ED-like sx
psych conditions “”
med: seizure disorders, CJD, Cushings Syndrome, others
psych: dementia, depression cause lack of appetite
epidemiology keys: AN
women:men
peak age of onset
3:1 women:men
peak age of onset: 14-18
epidemiology keys: BN
higher prevalence for subthreshold BN
approx 75% female
onset: late adolescence-young adulthood
